Improving the Sex Life of Aging Men Through Supplementation

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As men age, sexual desire and function can decline. Poor sexual function is often associated with age-related declines in testosterone levels, also known as late onset hypogonadism (LOH). In fact, while the underlying mechanisms of this condition are not well understood, symptoms related to sexual dysfunction may be a reliable indicator that a person is experiencing LOH. For example, one study surveyed a population sample of 3,396 men between the ages of 40 and 70 at eight European centers, using questionnaires to measure their general, sexual, physical, and psychological health. Researchers also measured levels of total testosterone and free testosterone. Results showed that “symptoms of poor morning erection, low sexual desire, erectile dysfunction (ED), inability to perform vigorous activity, depression, and fatigue were significantly related to the testosterone level.” Researchers noted that the three sexual symptoms in particular had a syndromic association with decreased testosterone levels.¹

That said, low testosterone is only one piece of the puzzle. Notably, when it comes to ED, the condition only has a weak association with low testosterone, and most data indicates that ED shares risk factors with cardiovascular diseases and may be a marker of cardiovascular mortality and morbidity.² In fact, another study on the same population of 3,396 European males found that 50% of the men reported one or more morbidities with hypertension, obesity, and heart diseases being the most prevalent. That study showed that as a function of age, sexual health declined while comorbidities increased.³ There is even a name for the type of atherosclerosis that causes ED, peripheral artery disease (PAD). Vascular diseases such as PAD are likely the cause of ED in 50-70% of men who experience it.⁴ Therefore, strategies that target cardiovascular health may be beneficial to reduce one’s risk of developing symptoms such as ED.

Many pharmaceutical solutions exist to treat symptoms of sexual dysfunction and low testosterone. Dietary supplements are by no means a way to replace these solutions for people who need them, but supplements may offer consumers a way to get ahead of these common symptoms of aging to improve their quality of life and age with dignity.

Active Aging and Sexual Health

Given the number of comorbidities that exist with age-related declines in testosterone levels, certain lifestyle factors may influence testosterone levels, particularly if those factors lead to a rise in obesity, cardiovascular disease, and metabolic conditions. One review found that interventions such as diet and exercise may help increase testosterone levels.⁵ According to that review, the results of 21 studies indicate that low calorie diet results in a significant increase in total testosterone. After a meta-regression analysis, researchers determined that with each 5 kg reduction of weight, there was a one nmol/L increase of testosterone. Similarly, the same review found that combining the results of eight studies indicated that physical exercise resulted in a significant increase in total testosterone levels at endpoint.

Age-related declines in testosterone are also a factor in the decline in muscle mass when men age. This is because muscle cells have receptors called androgen receptors that testosterone binds to in order to maintain muscle fibers. Declines in testosterone can therefore translate to muscle degradation which leads to weakness and low energy in men.⁶ It’s therefore no surprise that many dietary supplement formulas targeting aging men and testosterone also promote muscle health and sports performance. This may be an effective approach to helping aging men because they have the potential to support low testosterone and comorbidities by encouraging physical activity and an overall healthy lifestyle.

A standardized fenugreek extract from Gencor (Austin, TX), called Testofen, has been found in research to both increase muscle strength and testosterone levels in participants. One recent study, for example, investigated the effects of the extract on 60 healthy males between the ages of 18 and 35. Participants were given either 300 mg of the extract or a matching placebo twice daily for eight weeks. They also participated in a supervised resistance training program for eight weeks. Results showed that those taking the extract experienced significant increases in strength, namely when it came to bench presses, compared to placebo, and saw a 98.7% increase in free testosterone from baseline. This increase was significant compared to placebo. Increases in total testosterone were not statistically significant.⁷

A different study of the same extract found improvements in libido following supplementation. In that study, 60 men between the ages of 25 and 52 without ED were randomized to receiver 600 mg of the extract or placebo for six weeks. Results showed that those taking the extract experienced an overall positive effect on physiological aspects of libido such as sexual arousal based on the Derogatis Interview for Sexual Functioning – Self Report.⁸

A newly launched standardized blend of East Indian Globe Thistle (Spaeranthus indicus) and Mango Tree Bark (Mangifera indica) called TestFactor, from PLT Health Solutions (Morristown, NJ), may also be a promising solution for supporting testosterone levels and sexual health. The company recently announced the results of a yet-to-be-published placebo-controlled study investigating the effects of a 325 mg/day dose of TestFactor on 60 sexually healthy, non-obese, recreationally active men for eight weeks. Results showed that after eight weeks, men taking the extract saw a 19% increase in total testosterone and a 20% increase in free testosterone compared to baseline values , as well as a 48% inprovement in sexual function. The increase in sexual function included a 58% improvement in sexual frequency, a 45% improvement in sexual interest, a 49% improvement in erections, and a 44% improvement in pleasure.

Similarly, a proprietary extract of Spilanthes acmella (SA3X from NutraShure Distribution, based in East Setauket, NY) was shown to significantly increase muscle gain, specifically mid-upper arm circumference, and sexual activity in a population of 240 males taking 500 mg of the extract daily for two months.⁹ A placebo-controlled study on 448 participants between the ages of 18 and 45 with self-reported symptoms of ED found that supplementation with the same extract at 500 mg daily resulted in significant decreases in ED symptoms after one month, based on the Men’s Sexual Health Questionnaire.¹⁰ This extract may also positively impact testosterone levels, but more research is necessary. Interestingly, research shows that these increases in testosterone appear to be stunted in people with conditions like diabetes and high cholesterol.¹¹

This brings us back to the comorbidities of ED and the need to consider turning around biomarkers of heart health and metabolic health in order to improve one’s sexual function. For example, a study investigating the impacts of the French maritime bark extract, Pycnogenol from Horphag Research (Geneva, Switzerland), on people ED with and without diabetes showed that the extract was able to significantly improve erectile function by 45% while also lowering levels of total cholesterol, LDL-cholesterol, and blood glucose in patients with diabetes.¹²

If we’re looking at sexual function as a factor of aging, it may also be worth considering how an ingredient impacts symptoms of aging more broadly. A proprietary blend of standardized Punica granatum fruit rind and Theobroma cocoa seed extracts marketed as Tesnor by Gencor was investigated specifically for its impact on aging males. In that study, participants between the ages of 36 and 55 were given either placebo, 200 mg, or 400 mg of the extract each day for 56 days. Researchers measured symptoms with the aging males’ symptoms (AMS) survey that contains 17 items related to psychological, somatic, and sexual subscales. Results showed that both doses significantly reduced AMS symptom scores after 56 days by 15.51% and 19.30% for the 200 mg and 400 mg doses, respectively. Testosterone levels were also measured, and results showed that free testosterone increased by 39.16% and 49.28% and total testosterone increased by 21.39% and 24.56% in the 200 mg and 400 mg group, respectively.¹³

Similarly, an extract of Eurycoma longifolia marketed as LJ100 by HP Ingredients (Bradenton, FL) was shown to significantly increase total testosterone at doses of 100 and 200 mg over the course of four weeks, while also significantly reducing AMS scores and Fatigue Severity Scale scores in participants between the ages of 50 and 70.¹⁴

Priorities

While reductions in libido with age are not abnormal, declines in sexual function such as ED are often a symptom of a larger problem. Dietary supplements may help support testosterone levels to a point but they should overall be viewed as a way to improve the quality of life in aging men by helping them be more active physically so that they can reduce their risk of developing or slow the progression of comordities like cardiovascular and metabolic conditions. All this can translate to better sexual function and activity in men, further improving their quality of life and confidence as they age.

References

1. Wu, F.C.W.; Tajar, A.; Beynon, J.M.; Pye, S.R.; Silman, A.J.; Finn, J.D.; O’Neill, T.W.; Bartfai, G.; et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N. Engl J Med. 2010. 363 (2), 123-135. DOI: 10.1056/NEJMoa0911101
2. Corona, G.; Maggi, M. The role of testosterone in male sexual function. Rev Endocr Metab Disord. 2022. 23(6), 1159-1172. DOI:10.1007/s11154-022-09748-3
3. Corona G.; Lee, D.M.; Forti, G.; O’Connor, D.B.; Maggi, M.; O’Neill, T.W.; Pendleton, N.; Bartfai, G.; et al. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). J Sex Med. 2010, 7 (4 Pt 1), 1362-1380. DOI:10.1111/j.1743-6109.2009.01601.x
4. Erectile Dysfunction and Vascular Disease. WebMD. September 9, 2023. https://www.webmd.com/erectile-dysfunction/vascular-disease-ed (accessed 2024-11-22).
5. Corona, G.; Rastrelli, G.; Morelli, A.; Sarchielli, E.; Cipriani, S.; Vignozzi, L.; Maggi, M. Treatment of Functional Hypogonadism Besides Pharmacological Substitution. World J Mens Health. 2019. 38 (3), 256-270. DOI:10.5534/wjmh.190061
6. Low Testosterone and Muscle Mass. Mount Sinai. April 8, 2014. https://www.mountsinai.org/about/newsroom/2014/low-testosterone-and-muscle-mass (Accessed 2024-11-21).
7. Wankhede, S.; Mohan, V.; Thakurdesai, P. Beneficial effects of fenugreek glycoside supplementation in male subjects during resistance training: a randomized controlled pilot study. J Sport Health Sci. 2016, 5 (2): 176-182. DOI: 10.1016/j.jshs.2014.09.005
8. Steels, E.; Rao, A.; Vitetta, L. Physiological aspects of male libido enhanced by standardized Trigonella foenum-graecum extract and mineral formulation. Phytother Res. 2011, 25 (9): 1294-1300. DOI: 10.1002/ptr.3360)
9. Pradhan, N.R.; Mishra, K.G.; Patnaik, N.; Nayak, R. Evaluation of effects of Spilanthes acmella extract on muscle mass and sexual potency in males: A population-based study. J Family Med Prim Care. 2021, 10 (11): 4242-4246. DOI: 10.4103/jfmpc.jfmpc_746_21
10. Patnaik, N.; Mishra, K.G.; Pradhan, N.R. Randomized, Triple-Blinded, Placebo-Controlled Trial of SA3X (Spilanthes acmella) for the Management of Erectile Dysfunction. Cureus, 2022, 14 (4): e23989. DOI: 10.7759/cureus.23989
11. Patnaik, N.; Mishra, K.G.; Pradhan, N.R. Evaluation of Serum Testosterone Levels Following Three Months of SA3X (Spilanthes acmella) Supplementation. Cureus, 2022, 14 (6): e26236. DOI: 10.7759/cureus.26236
12. Trebaticky B et al. “Natural polyphenols improve erectile function and lipid profile in patients suffering from erectile dysfunction.” Bratislava Medical Journal. 2019, 120 (12), 941-944. DOI: 10.4149/BLL_2019_158
13. Pandit, S.L.; Yaligar, D.; Halemane, M.; Bhat, A. A proprietary blend of standardized Punica granatum fruit rind and Theobroma cocoa seed extracts mitigates aging males’ symptoms: a randomized, double-blind, placebo-controlled study. Int J Med Sci. 2022, 19 (8): 1290-1299. DOI: 10.7150/ijms.73645
14. Chinnappan S.M.; George, A.; Pandey, P.; Narke, G.; Choudhary, Y.K. Effect of Eurycoma longifolia standardised aqueous root extract–Physta® on testosterone levels and quality of life in ageing male subjects: a randomised, double-blind, placebo-controlled multicentre study. Food Nutr Res. 2021. 65. DOI: 10.29219/fnr.v65.5647